Created Feb 2002
Reviewed Dec 2019
Patient is standing in the surf and is knocked over by heavy waves, admitted with a fracture tibial plateau. Is it appropriate to use two external codes to reflect the most accurate picture; X39 Exposure to other and unspecified forces of nature and/or W18.8 Other specified fall on same level?
Yes. ACS 2001 External cause code use and sequencing states that more than one external cause code can be assigned if the additional code(s) are required to classify the clinical concept. In this case W18.8 Other specified fall on same level would be sufficient. X39 Exposure to other and unspecified forces of nature describes tidal waves. Choppy stormy seas are not tidal waves.